| Abdominal versus vaginal cerclage after a failed transvaginal cerclage: a systematic review. | |
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MedLine Citation:
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PMID: 12388966 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The purpose of this study was to compare the outcomes of pregnancy after transabdominal cerclage versus after transvaginal cerclage in patients with a failed transvaginal cerclage during a previous pregnancy. STUDY DESIGN: MEDLINE and EMBASE were searched in English. We included studies that reported perinatal and/or maternal outcomes in women who had a transabdominal cerclage or a transvaginal cerclage placed at or before 20 weeks of gestation, after having had a failed nonemergent transvaginal cerclage in a previous pregnancy. Data were included for individual patients if they met the inclusion criteria, and their outcomes were reported separately. We excluded patients with cervical amputation because transvaginal cerclage is not an option for these women because of technical difficulty. RESULTS: Fourteen studies met the inclusion criteria. Thirteen of the studies were case series (12 retrospective and 1 prospective), and one study was a retrospective cohort study. In total, 157 women in the studies had a failed vaginal cerclage in a previous pregnancy; 117 women had a subsequent transabdominal cerclage; 40 women had a subsequent transvaginal cerclage. The likelihood of perinatal death or delivery at <24 weeks was 6.0% (95% CI, 3.8%-8.2%) after transabdominal cerclage and 12.5% (95% CI, 2.7%-22.7%) after transvaginal cerclage. The likelihood of serious operative complications after transabdominal cerclage was 3.4% (95% CI, 0.01%, 6.8%). There were no serious operative complications after transvaginal cerclage. CONCLUSION: Transabdominal cerclage may be associated with a lower risk of perinatal death or delivery at <24 weeks of gestation, but it may be associated with a higher risk of serious operative complications. A multicenter randomized controlled trial should be conducted to address this question. |
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Authors:
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Veena Zaveri; Fariba Aghajafari; Kofi Amankwah; Mary Hannah |
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Publication Detail:
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Type: Comparative Study; Journal Article; Review |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 187 ISSN: 0002-9378 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2002 Oct |
Date Detail:
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Created Date: 2002-10-21 Completed Date: 2002-11-19 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 868-72 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynecology, Sunnybrook and Women's College Health Sciences Center, University of Toronto, Toronto, Ontario, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdomen Cerclage, Cervical / methods* Female Humans Infant Mortality Infant, Newborn Likelihood Functions Pregnancy Pregnancy Outcome Retreatment Treatment Failure Vagina |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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